Early Onset Of Heart Disease Coupled With Rapid Transition Through Menopause

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Women who transition more quickly through menopause are at increased risk for a higher rate of progression of "preclinical atherosclerosis" - narrowing of arteries caused by the thickening of their walls, concludes a new study.

While fifty-two women were premenopausal, 20 were perimenopausal and 131 were postmenopausal, none of them had been diagnosed with cardiovascular disease.

They were evaluated when they entered the study and at two 18-month intervals, providing a snapshot over a three-year period of time.

Evaluations included carotid intimal-media thickness (cIMT) measurements and objective measures of menopausal status based on hormone levels and physiologic changes, not subjective factors, such as hot flashes and estimates of menstrual cycling.

It was found that women who transitioned from being premenopausal to being fully postmenopausal within three years had more build-up of fatty plaque in their carotid arteries.

Thus the researchers suggested that women who transition through menopause rapidly are at greater risk of early development of heart disease.

"We know that more fatty plaque accumulation predicts future heart attacks and strokes, but this is our first venture into this particular line of inquiry. This is an observational study, which doesn't provide specific recommendations for patient evaluation and treatment, but it does raise questions," said Bairey Merz.

She added: "The findings suggest that we study this more definitively to possibly determine if women undergoing a more rapid menopause might benefit from early hormone replacement therapy.

"In the meantime, physicians could consider using carotid intimal-media thickness measurement or other cardiovascular screenings for women who are rapidly transitioning or who have certain risk factors, such as cigarette smoking or chemotherapy, which are known to accelerate transition through the menopause."

However, she cautioned that patients should not use the study to self-diagnose or presume they may be at higher risk because of symptoms.

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